Some headline projections
> Scotland’s 65+ population projected to rise by 21% between 2006 - 2016
> By 2031 it will have risen by 62%
> For the 85+ age group specifically, a 38% rise is projected for 2016
> And, for 2031, the increase is 144%
Past trend in Emergency Admission Bed Days for people aged 65 and over
2,400,000
2,500,000
2,600,000
2,700,000
2,800,000
2,900,000
1998/99 1999/00 2000/01 2001/02 2002/03 2003/04 2004/05 2005/06 2006/07
Financial year
no
.of
bed
day
s
HEAT
Demographic change for population aged 65+ ScotlandPotential impact on emergency bed numbers 2007-2031
0
2000
4000
6000
8000
10000
12000
14000
16000
Y/E Mar 2007 Projected2011
Projected2016
Projected2021
Projected2026
Projected2031
Year
Be
ds
9%24%
41%
61%
84%
Calendar year ’07 estimate
P Knight Scottish Government
Demographic change for population aged 65+ Scotland Potential impact on specialist care services 2007-2031
0
40000
80000
120000
160000
200000
Actual2007
2011 2016 2021 2026 2031
N of
peo
ple
1-9 hrsHome care
10+ hrsHome care
Care Home
Cont h/care (hosp)
Projection
26%
94%
P Knight Scottish Government
Health and social care expenditure Scottish population aged 65+ (2007/08 total=£4.5bn)
Other Social Work
Care Homes
Home Care
FHS
PrescribingCommunity
Other Hospital care
Emergency admissions
£1.4bn
£0.8bn£0.4bn
£0.4bn
£0.4bn
£0.3bn
£0.6bn£0.2bn
Projected Health and Social care expenditure for Scottish populatiion aged 65+
0
1,000
2,000
3,000
4,000
5,000
6,000
7,000
8,000
9,000
2007/08 Actual 2011 2016 2021 2026 2031
£m
NHS Social Work
22%
74%
Extracts From:
Re-shaping Care for Older People Joint Leadership Summit
19th May 2009
Colin Mair, Chief Executive
Improvement Service
Finance & Demand 2009/10 – 2013/14 (% terms)
0
-2.04
-5.78
-9.18
-12.9
0
-2.04
-3.74
-5.44
-7.14
0
-2.04 -2.04 -2.04 -2.04
0
2
4
6
8
-15
-10
-5
0
5
10
2009/10 2010/11 2011/12 2012/13 2013/14
IFS
CPPR
UKTreasuryDemand
Budget & Demand Changes (Real Terms) 2009/10 – 2013/14
-13
-3.8
8.1
-2
-7
-14.5
-9.5
-4.5
0.5
5.5
Budget % Change Budget Cash Change(£Bn)
Demand Growth (%)
IFS
CPPR
The Treasury Forecasts
> Assumes more than trend rate of economic growth by 2012/13
> We will borrow at least £712 billion across next 5 years (we borrowed in total £500 billion across the last 350 years)
> We have not come out of any previous recession (1970’s, 1980’s, 1990’s) in this way
> 1.5 million unemployed still assumed
Longer Term (13/14 – 17/18)
> Structural gap in public finance opening up – 6.3% national income by 2017/ 18
> Tax rises & spending cuts (25/75 balance) will claw back 50%, remainder to be identified – “2 Parliaments of pain”
> If 25/ 75 balance maintained spending will rise 1% real terms per annum maximum across next 20 years
An Outcomes focus – What it means
> Frail and vulnerable people supported to live at home
> Control and decisions with the individual> Strong, caring, supportive communities> Fairness and equity> High quality environment> Contributing to local economy
Current service provision by service type
People aged 65 and over
hospital est
care home
home care
all others
Some further Considerations
> Tenure implications – an equity stake> ‘Young until your dead’ – self image> Economically active> Politically active and influential> Best healthy life expetancy prospects> Pension provision> Older people provide far more care than they
receive
Reshaping Care for older people …..
> Into the Spotlight Conference (Dec 08)>Lord Sutherland Review of Free Personal and Nursing Care (Dec 08)>Ministerial Strategic Group (Dec 08-March 09)>Joint Leadership Summit (May 09)>Engagement from Nov
Reshaping Care for Older People … 8 workstreams
> Vision and engagement> Care at home – a mutual care> Care homes> Care pathways> Planning for ageing communities> Workforce> Healthy life expectancy> Demographics and funding
It has to be … outcomes
>How well do our services help achieve our policy goals?
>How can we help people stay out of the formal care system?
>How can we support self care?> Is it a change of philosophy and approach –
support not services?>We are doing it now – in pockets – what’s
stopping the spread?